It still, I think, unnecessarily remains a disputed question, whether the mental affection in general paralysis does, or does not, precede the symptoms that mark enfeebled muscular power. Esquirol, indeed, distinctly states, in speaking of the corporeal paralysis, tantôt elle précède le délire, but it must be clear that this is after all negative testimony, it only means that Esquirol has been told so; it can only go to prove, as a close examination of the case quoted by Calmeil proves, that there were no symptoms observed by the friends of the patient, to lead them to suspect insanity, before the paralysis appeared. It has always been taught by Dr. Conolly, that the mental symptoms are synchronous with, or antecedent to the paralysis, and this is consistent with Esquirol's conclusion, that general paralysis is a “complication of insanity“; a definition called out by the not very lucid objection of Dr. Burrows, that he, Esquirol, seemed to think the paralysis to be the “effect, and not the cause of the insanity.” The real question to be decided is, whether in an undoubted case of ‘general paralysis,’ with mental aberration, the paralysie générale of Calmeil, there has ever been a period of the malady during which, with the muscular affection distinct, the mental powers were unaffected ? I have never seen such a case, and with my strong opinion of the special nature of the disease, should not expect to do so; it has already been pointed out that the statement of the paralysis existing with ‘weakening of the intellect,’ only widens the question into a consideration, of how small an amount of weakening constitutes unsoundness of mind. The existence of a case ultimately becoming insane, presenting paralytic symptoms, and yet showing undiminished mental vigour for some time after they appeared, if recorded by a competent observer, would go far to shake the opinion held by many of our leading physicians, as well as by myself, that general paralysis is a disorder, sui generis, and, though neither ‘cause or effect’ of unsoundness of mind, inseparably connected with it. At present, no such case is on record.